HIV Prevention and "Click It or Ticket": Are New Devices Safe?

After doing research on new safety devices being proposed to protect drivers and passengers of automobiles, I have come to a conclusion: There is no need for an increase in new safety devices.

There are several reasons why we don't need more safety devices and quite honestly it angers me when people suggest that we do. It is all about choices. If people follow laws, traffic signs and speed recommendations then we would see a huge reduction in traffic accidents and mortality rates.

Additionally, as drivers embrace new safety devices such as airbags, anti-lock brakes and seat belts it will obviously promote and ultimately facilitate an increase in reckless and careless driving. Not to mention that these new (and unproven) "safety" measures will also mean that people are driving more. This will inherently increase the statistical odds of more accidents.

Am I saying that accidents never happen? No! For the most part however, people who follow the rules rarely get into accidents. There is also the issue of compliance. If people truly want to avoid auto accidents, then all they have to do is follow the rules of the road. These new "safety devices" that are being proposed by certain groups have only proved to be effective when used.

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These same groups should also talk about the risk of injury posed to drivers and passengers of the vehicle should an airbag be deployed or anti-lock brakes lock up during a skid. There have been reports of side effects such as bruises, contusions, whiplash and even death as a result of the deployment of these new safety devices. More research needs to be conducted concerning how we can reduce these risks and increase driver/passenger safety-device utilization.

Next there is the cost of implementing use of these new "safety devices." How will it be paid for? Will insurance companies and auto-manufacturers be receptive to these new costs? To some extent this simply looks like an effort by the auto industry to bolster market share and to pad the pockets of shareholders. What data we have showing the efficacy of safety devices in automobiles has all been driven by the auto industry, so is there an issue of biased data sets?

In my opinion, we should not be pouring more money into safety measures that might work but instead use that money for increased education. Drivers simply need to use better choices when they get behind the wheel of a vehicle.

Now re-read this entire article and consider if this entire piece were about HIV pre-exposure prophylaxis (PrEP). The above stated arguments are the same ones that I hear each and every day regarding the use of PrEP. Many in the community feel as if we simply do not need anything other than condoms to fight and end new HIV infections. The "condom-only" message is falling on deaf ears and if we are serious about addressing those who are at greatest risk of becoming infected with HIV then we must embrace new technologies such as PrEP. We must consider PrEP even if there are those in the community who rail against anything other than condoms.

These are the same people who believe that the risk of harm/side effects exceeds the potential benefits. They seemingly fail to inform people that when taken consistently PrEP has been proven to reduce HIV infection by up to 99 percent. Just as risk-reduction (following traffic laws/speed limits) lowers the risk of having an auto accident, we must also adopt safety measures for those who will not embrace traditional risk-reduction strategies (condoms). By continuing to perpetuate the ill-conceived notion that "condoms alone" are going to end new HIV infections, you sound just as ridiculous as the statements presented at the start of this article.

Comment by: ProceedWithCaution
(Boston, MA)
Fri., Jan. 31, 2014 at 10:55 am EST
Clever comparison of safety to illustrate a point. PrEP is a great prevention tool when it is targeted to specific high-risk individuals and when those being prescribed use additional methods to prevent disease transmission and get screened frequently for STIs (which is the protocol).
However, this analogy overlooks additional motivational factors around car “safety devices" that do not exist around sexual health: regarding driving, safety features do not encourage people to drive recklessly because there are additional negative consequences that strongly motivate people to drive safely—getting a ticket, get dropped by an insurance company, getting sued, license suspension, etc. There are not similarly compelling consequences for people on PrEP to wear condoms. Sure, there are other STIs out there, but they are largely treatable (except for the antibiotic-resistant strains of gonorrhea). If other sexually transmitted diseases are easy to treat, will people have compelling reasons to use condoms?
Studies suggest that condom use is inconsistent and on the decline, and it is imperative that PrEP users do not forgo condoms because of a sense of security (“risk compensation”). PrEP could create an environment similar post sexual revolution, where people had many partners and did not use barriers, which allowed HIV to proliferate. We must not set the stage for an increase in other sexually transmitting infections and/or the rise of new infectious diseases.
Secondly, regarding car safety features, the consumer bears the burden of paying for safety features when they purchase a car. When a person goes on PrEP, the community bears the $10K/yr cost, whether it is through government health care(taxes) or private insurance (shared insurance pool). In the long run, PrEP could save money by preventing new HIV infections--but only if it is not prescribed frivolously, to people who are not high risk, and if PrEP does not lead to an increase in other STIs or new diseases.

The paragraph beginning, "Next there is also the cost of implementing use of these new 'safety devices.' How will it be paid for?" - well if you change that to HIV PrEP instead of auto safety it's still perfectly valid. Condoms cost next to nothing; Truvada costs a fortune.

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